Why Do States Need Home- & Community-Based Services Waivers?

In the United States, most long-term care is paid for through Medicaid, which has historically been provided in a nursing facility or other institutional setting. Since state governments are picking up most of the tab for long-term care, there has been ongoing interest in the financing and delivery of long-term care services.

In 1983, Congress authorized 1915(c) of the Social Security Act, which provided a new alternative to the delivery of long-term care services. This law allowed states to use Medicaid not only to provide institutional long-term care, but also to provide home and . . .